The present invention relates to a system and method for teaching and training students in medical procedures, and in particular to a system and method for training students in the procedure of endoscopy on a subject which includes the complication of the presence of bleeding from the subject.
Endoscopy, and in particular flexible gastro-endoscopy, are examples of minimally invasive medical procedures. Flexible gastro-endoscopy is an important medical tool for both surgical and diagnostic procedures in the gastro-intestinal tract. Essentially, gastro-endoscopy is performed by inserting an endoscope, which is a flexible tube, into the gastro-intestinal tract, either through the mouth or the rectum of the subject. The tube is manipulated by a trained physician through specialized controls. The end of the tube which is inserted into the subject contains a camera and one or more surgical tools, such as a clipper for removing tissue samples from the gastro-intestinal tract. The physician must maneuver the tube according to images of the gastro-intestinal tract received from the camera and displayed on a video screen. The lack of direct visual feedback from the gastro-intestinal tract is one factor which renders endoscopy a complex and difficult procedure to master. Such lack of feedback also increases the difficulty of hand-eye coordination and correct manipulation of the endoscopic device. Thus, flexible gastro-endoscopy is a difficult procedure to both perform and to learn.
Currently, students are taught to perform flexible gastro-endoscopy according to the traditional model for medical education, in which students observe and assist more experienced physicians. Unfortunately, such observation alone cannot provide the necessary training for such complicated medical procedures. Students may also perform procedures on animals and human cadavers, neither of which replicates the visual and tactile sensations of a live human patient. Thus, traditional medical training is not adequate for modern technologically complex medical procedures.
In an attempt to provide more realistic medical training for such procedures, simulation devices have been developed which attempt to replicate the tactile sensations and/or visual feedback for these procedures, in order to provide improved medical training without endangering human patients. An example of such a simulation device is disclosed in U.S. Pat. No. 5,403,191, in which the disclosed device is a box containing simulated human organs. Various surgical laparoscopic procedures can be performed on the simulated organs. Visual feedback is provided by a system of mirrors. However, the system of both visual and tactile feedback is primitive in this device, and does not provide a true representation of the visual and tactile sensations which would accompany such surgical procedures in a human patient. Furthermore, the box itself is not a realistic representation of the three-dimensional structure of a human patient. Thus, the disclosed device is lacking in many important aspects and fails to meet the needs of a medical simulation device.
Attempts to provide a more realistic experience from a medical simulation devices are disclosed in PCT Patent Application Nos. WO 96/163 89 and WO 95/02233. Both of these applications disclose a device for providing a simulation of the surgical procedure of laparoscopy. Both devices include a mannequin in the shape of a human torso, with various points at which simulated surgical instruments are placed. However, the devices are limited in that the positions of the simulated surgical instruments are predetermined, which is not a realistic scenario. Furthermore, the visual feedback is based upon a stream of video images taken from actual surgical procedures. However, such simple rendering of video images would result in inaccurate or unrealistic images as portions of the video data would need to be removed for greater processing speed. Alternatively, the video processing would consume such massive amounts of computational time and resources that the entire system would fail to respond in a realistic time period to the actions of the student. At the very minimum, a dedicated graphics workstation would be required, rather than a personal computer (PC). Thus, neither reference teaches or discloses adequate visual processing for real time visual feedback of the simulated medical procedure.
Similarly, U.S. Pat. No. 4,907,973 discloses a device for simulating the medical procedure of flexible gastro-endoscopy. The disclosed device also suffers from the deficiencies of the above-referenced prior art devices, in that the visual feedback system is based upon rendering of video data taken from actual endoscopic procedures. As noted previously, displaying such data would either require massive computational resources, or else would simply require too much time for a realistic visual feedback response. Thus, the disclosed device also suffers from the deficiencies of the prior art.
Furthermore, the background art currently does not teach or suggest a device or system which would teach the student how to handle a pathological, abnormal situation, such as that which occurs when bleeding from the patient occurs. Such bleeding may occur before and/or during the procedure of gastro-endoscopy, for example from different types of ulcers in the gastro-intestinal tract, tears to this organ, tumors and other lesions. Bleeding from the gastrointestinal tract is a highly dangerous medical emergency, which must be handled appropriately by the medical doctor. Thus, the lack of such a device or system for teaching the student how to recognize and handle different types of bleeding from the subject of an endoscopic procedure is clearly a deficiency of the background art.
A truly useful and efficient medical simulation device for minimally invasive therapeutic procedures such as endoscopy would give real time, accurate and realistic visual feedback of the procedure, and would also give realistic tactile feedback, so that the visual and tactile systems would be accurately linked for the simulation as for an actual medical procedure. In addition, such a simulation device would also be able to simulate situations in which the subject of the minimally invasive therapeutic procedure is bleeding from an organ and/or organ area or system being examined during the procedure. The simulation should preferably include situations in which bleeding begins before the procedure is started, and bleeding which is initiated during the procedure itself. Such simulation of bleeding would enable the student to recognize this dangerous condition, and to also be able to properly treat the medical emergency in a calm manner. Unfortunately, such a simulation device and/or system is not currently taught or provided by the background art.
There is therefore a need for, and it would be useful to have, a method, device and system to simulate a minimally invasive medical procedure such as endoscopy, which would provide accurate, linked visual and tactile feedback to the student and which would serve as a training resource for all aspects of the procedure, particularly including the recognition and treatment of the emergency condition of bleeding from the organ and/or organ area or system under examination by the minimally invasive medical procedure.